American journal of preventive medicine
-
With concerns about tobacco use being a risk factor for severe disease from COVID-19, understanding nicotine- and tobacco-use patterns is important for preventive efforts. This study aims to understand changes in combustible cigarette and E-cigarette use among U.S. adults. ⋯ Cigarette and E-cigarette use patterns varied in response to the COVID-19 pandemic. Most cigarette smokers and E-cigarette users perceived product use as increasing COVID-19‒related health risks, and this was associated with attempts to quit. Some cigarette smokers, especially those reporting higher stress, increased product use. Proactive provision of cessation support to smokers and E-cigarette users may help mitigate the stress-related increases in product use during the COVID-19 pandemic.
-
The U.S. has a higher adolescent pregnancy rate than other industrialized countries. School-based health centers can improve access to contraceptives among youth, which can prevent unplanned pregnancies. This cross-sectional study examines the characteristics and predictors of contraceptive provision at school-based health centers in 2016-2017 and changes in and barriers to provision between 2001 and 2017. ⋯ School-based health centers are an evidence-based model for providing contraceptives to adolescents but not enough are providing direct access. Understanding the predictors, characteristics, and barriers influencing the provision of contraceptives at school-based health centers may help to expand the number doing so.
-
In response to the opioid overdose crisis, providers were urged to taper and discontinue patients from long-term opioid therapy; however, abrupt discontinuation may lead to poor health outcomes. This study aims to determine abrupt and tapered discontinuation rates and identify the patient and provider characteristics associated with abrupt discontinuation. ⋯ Among all long-term opioid therapy discontinuations, abrupt discontinuation is increasing. Evidence-based approaches to managing and tapering long-term opioid therapy are urgently needed.
-
The Patient Protection and Affordable Care Act eliminated cost sharing for preventive services, including colorectal cancer screening for individuals aged 50-75 years with private health insurance. This study examines the impact of the Affordable Care Act's removal of cost sharing for colorectal cancer screening on colorectal cancer incidence and mortality. ⋯ The elimination of cost sharing for colorectal cancer screening due to the Affordable Care Act was associated with a decrease in age-, race/ethnicity-, and sex-adjusted colorectal cancer incidence and colorectal cancer‒related mortality, implying that policies that remove barriers to screening, particularly financial burden from cost sharing, can result in improved colorectal cancer outcomes.
-
Opioid use disorder and high-risk opioid prescription increase the risks for overdose and death. In Veterans, military sexual trauma is associated with increased risk for assorted health conditions. This study evaluates the association of military sexual trauma with opioid use disorder and high-risk opioid prescription and potential moderation by gender. ⋯ Military sexual trauma was a significant risk factor for opioid use disorder and high-risk opioid prescription, with the former association particularly strong in men. Clinical care for Veterans with military sexual trauma should consider elevated risk of opioid use disorder and high-risk opioid prescription.